While other industries take as their focus such shallow concerns as the making of money, the health care profession prides itself on dealing with matters of life and death. But that’s not the only thing distinguishing health care from other industries: it is also unique in the extent to which it excludes consumers from important decisions. Employers predetermine which health plans are available to you; insurers select what network of physicians you can see. Bring your own health research to the doctor’s office, and you might be labeled a nuisance patient. Question your doctor’s recommendations, and you could be called noncompliant or difficult.

Doctors and patients alike are accustomed to the firmly entrenched Doctor Knows Best status quo. But it is only by empowering patients – entrusting them with greater responsibility and putting opportunities for self-directed care into their hands – that health care can be made significantly more efficient and effective. It's a bit late, of course, to work patient empowerment into the various proposals now wending their way through Congress. But anything that can be called true reform may be impossible without it.

Already, advances in scientific knowledge and medical technology are enabling some patients to monitor their health and control their own diseases. Insulin-dependent diabetics, for example, quickly learn how to manage their blood glucose levels at home by matching their insulin dosage to changes in their diet and physical activity. Many diabetics have also joined online communities to share information and advice, sometimes viewing each other as more trusted advisors than their own doctors. Diabetics who take their health in hand in this way find that the cost of care decreases dramatically, while the quality increases: it’s far more effective than relying on experts whom they may see only every few months.

This kind of consumer empowerment has similarly transformed a number of other industries. Rather than hiring accountants, for example, many now turn to software programs like TurboTax and QuickBooks to do taxes or manage small business finances. And instead of calling a stockbroker or visiting a bank branch, many routinely do trading and banking online.

Likewise, while travel agents still provide valuable assistance with complex arrangements, most people now plan and book their trips themselves. Rather than using real estate agents, many homebuyers and renters turn to Craigslist or other “For Sale By Owner” web sites. Instead of visiting multiple dealers, car buyers, too, now do most of their research and comparison shopping at home. This pattern of cutting out unnecessary middlemen by empowering non-experts, sometimes called "disintermediation," is part of a process we’ve termed “disruptive innovation,” and it’s vital to making costly products and services much more affordable over time.

Given all this, shouldn’t the health care system be able to do for all patients what it’s already done so effectively for diabetics?

An obstacle thus far has been an entrenched set of paternalistic attitudes on the part of health care providers. The health care system, after all, is designed to address our most complicated medical problems, which is why becoming a doctor requires such rigorous, sophisticated training. But this leads to a general sense on the part of physicians that health care of any kind is too delicate a matter for non-experts. And while there’s no question that complex medical procedures and assessments should remain in the hands of professionals, there is much that could be effectively dealt with by patients themselves.

One area where patients could become more involved is in the management of their own medical records. Health records have long been considered holy scripture—to be modified and interpreted by nobody less than a health care professional. But patients could be valuable contributors to their health records if only they were allowed access. Understandably, the notion of health records becoming fully accessible to and modifiable by patients – as well as portable across different health systems—raises concerns among some providers about accuracy and privacy. But patients ought to be viewed as partners in managing and keeping track of this information. After all, it’s in their own interest to ensure that their records are accurate and complete. And if implemented properly, patient-controlled records could relieve providers of many of the administrative headaches related to maintaining and securing health data.

Another opportunity for patient empowerment lies in online patient communities. Some professionals regard interactive medical web sites with suspicion, fearing that they enable the spread of misinformation among laypeople. This worry is not unfounded, but the simple fact is that patients are already drawing upon user-generated content, like Wikipedia and online discussion boards, to gather health information. Rather than trying to shut these sites down or ignore them, physicians could actively participate, thereby offering correctives to any misperceptions. Clearly there’s a market for it: patients have been creating these communities precisely because they’re clamoring for information that they’re not getting from their physicians. And in the event of a pandemic or other widespread health emergency, accurate information could more efficiently be dispensed in this way than by speaking with one patient at a time.

Finally, implementing a ratings system for health care providers would empower not only patients (who could make more informed choices about whom they want to see) but also doctors, who could fine-tune their services in response to feedback. Most physicians have so far resisted any type of consumer ratings system because they believe that patients aren’t qualified to judge them. But while that may be true in some respects, there are plenty of service-oriented aspects of the clinical experience that are important to patients, but which are too often ignored by providers. Other industries ignore service flaws at their peril. Health care should be no different.

Real reform will only happen if we are willing to upend existing models. But if it’s only the usual stakeholders who are brought into the reform process, change will end up being merely incremental, because hospitals, physicians, and other health industry groups simply can’t imagine a world without them in it. As Henry Ford once said, of his invention of the automobile, “If I had asked people what they wanted, they would have said faster horses.”

So far, there’s no general patient lobby that receives the same attention, or possesses the same financial resources, as the American Medical Association and American Hospital Association. But surely if more patients realized how much influence they could have in their own care, they would discard their roles as passive health care consumers, and would instead become its agents of change.

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Writing used to be a solitary profession. How did it become so interminably social?

Whether we’re behind the podium or awaiting our turn, numbing our bottoms on the chill of metal foldout chairs or trying to work some life into our terror-stricken tongues, we introverts feel the pain of the public performance. This is because there are requirements to being a writer. Other than being a writer, I mean. Firstly, there’s the need to become part of the writing “community”, which compels every writer who craves self respect and success to attend community events, help to organize them, buzz over them, and—despite blitzed nerves and staggering bowels—present and perform at them. We get through it. We bully ourselves into it. We dose ourselves with beta blockers. We drink. We become our own worst enemies for a night of validation and participation.

Even when a dentist kills an adored lion, and everyone is furious, there’s loftier righteousness to be had.

Now is the point in the story of Cecil the lion—amid non-stop news coverage and passionate social-media advocacy—when people get tired of hearing about Cecil the lion. Even if they hesitate to say it.

But Cecil fatigue is only going to get worse. On Friday morning, Zimbabwe’s environment minister, Oppah Muchinguri, called for the extradition of the man who killed him, the Minnesota dentist Walter Palmer. Muchinguri would like Palmer to be “held accountable for his illegal action”—paying a reported $50,000 to kill Cecil with an arrow after luring him away from protected land. And she’s far from alone in demanding accountability. This week, the Internet has served as a bastion of judgment and vigilante justice—just like usual, except that this was a perfect storm directed at a single person. It might be called an outrage singularity.

Forget credit hours—in a quest to cut costs, universities are simply asking students to prove their mastery of a subject.

MANCHESTER, Mich.—Had Daniella Kippnick followed in the footsteps of the hundreds of millions of students who have earned university degrees in the past millennium, she might be slumping in a lecture hall somewhere while a professor droned. But Kippnick has no course lectures. She has no courses to attend at all. No classroom, no college quad, no grades. Her university has no deadlines or tenure-track professors.

Instead, Kippnick makes her way through different subject matters on the way to a bachelor’s in accounting. When she feels she’s mastered a certain subject, she takes a test at home, where a proctor watches her from afar by monitoring her computer and watching her over a video feed. If she proves she’s competent—by getting the equivalent of a B—she passes and moves on to the next subject.

The Wall Street Journal’s eyebrow-raising story of how the presidential candidate and her husband accepted cash from UBS without any regard for the appearance of impropriety that it created.

The Swiss bank UBS is one of the biggest, most powerful financial institutions in the world. As secretary of state, Hillary Clinton intervened to help it out with the IRS. And after that, the Swiss bank paid Bill Clinton $1.5 million for speaking gigs. TheWall Street Journal reported all that and more Thursday in an article that highlights huge conflicts of interest that the Clintons have created in the recent past.

The piece begins by detailing how Clinton helped the global bank.

“A few weeks after Hillary Clinton was sworn in as secretary of state in early 2009, she was summoned to Geneva by her Swiss counterpart to discuss an urgent matter. The Internal Revenue Service was suing UBS AG to get the identities of Americans with secret accounts,” the newspaper reports. “If the case proceeded, Switzerland’s largest bank would face an impossible choice: Violate Swiss secrecy laws by handing over the names, or refuse and face criminal charges in U.S. federal court. Within months, Mrs. Clinton announced a tentative legal settlement—an unusual intervention by the top U.S. diplomat. UBS ultimately turned over information on 4,450 accounts, a fraction of the 52,000 sought by the IRS.”

There’s no way this man could be president, right? Just look at him: rumpled and scowling, bald pate topped by an entropic nimbus of white hair. Just listen to him: ranting, in his gravelly Brooklyn accent, about socialism. Socialism!

And yet here we are: In the biggest surprise of the race for the Democratic presidential nomination, this thoroughly implausible man, Bernie Sanders, is a sensation.

He is drawing enormous crowds—11,000 in Phoenix, 8,000 in Dallas, 2,500 in Council Bluffs, Iowa—the largest turnout of any candidate from any party in the first-to-vote primary state. He has raised $15 million in mostly small donations, to Hillary Clinton’s $45 million—and unlike her, he did it without holding a single fundraiser. Shocking the political establishment, it is Sanders—not Martin O’Malley, the fresh-faced former two-term governor of Maryland; not Joe Biden, the sitting vice president—to whom discontented Democratic voters looking for an alternative to Clinton have turned.

During the multi-country press tour for Mission Impossible: Rogue Nation, not even Jon Stewart has dared ask Tom Cruise about Scientology.

During the media blitz for Mission Impossible: Rogue Nation over the past two weeks, Tom Cruise has seemingly been everywhere. In London, he participated in a live interview at the British Film Institute with the presenter Alex Zane, the movie’s director, Christopher McQuarrie, and a handful of his fellow cast members. In New York, he faced off with Jimmy Fallon in a lip-sync battle on The Tonight Show and attended the Monday night premiere in Times Square. And, on Tuesday afternoon, the actor recorded an appearance on The Daily Show With Jon Stewart, where he discussed his exercise regimen, the importance of a healthy diet, and how he still has all his own hair at 53.

Stewart, who during his career has won two Peabody Awards for public service and the Orwell Award for “distinguished contribution to honesty and clarity in public language,” represented the most challenging interviewer Cruise has faced on the tour, during a challenging year for the actor. In April, HBO broadcast Alex Gibney’s documentary Going Clear, a film based on the book of the same title by Lawrence Wright exploring the Church of Scientology, of which Cruise is a high-profile member. The movie alleges, among other things, that the actor personally profited from slave labor (church members who were paid 40 cents an hour to outfit the star’s airplane hangar and motorcycle), and that his former girlfriend, the actress Nazanin Boniadi, was punished by the Church by being forced to do menial work after telling a friend about her relationship troubles with Cruise. For Cruise “not to address the allegations of abuse,” Gibney said in January, “seems to me palpably irresponsible.” But in The Daily Show interview, as with all of Cruise’s other appearances, Scientology wasn’t mentioned.

An attack on an American-funded military group epitomizes the Obama Administration’s logistical and strategic failures in the war-torn country.

Last week, the U.S. finally received some good news in Syria:.After months of prevarication, Turkey announced that the American military could launch airstrikes against Islamic State positions in Syria from its base in Incirlik. The development signaled that Turkey, a regional power, had at last agreed to join the fight against ISIS.

The announcement provided a dose of optimism in a conflict that has, in the last four years, killed over 200,000 and displaced millions more. Days later, however, the positive momentum screeched to a halt. Earlier this week, fighters from the al-Nusra Front, an Islamist group aligned with al-Qaeda, reportedly captured the commander of Division 30, a Syrian militia that receives U.S. funding and logistical support, in the countryside north of Aleppo. On Friday, the offensive escalated: Al-Nusra fighters attacked Division 30 headquarters, killing five and capturing others. According to Agence France Presse, the purpose of the attack was to obtain sophisticated weapons provided by the Americans.

The Islamic State is no mere collection of psychopaths. It is a religious group with carefully considered beliefs, among them that it is a key agent of the coming apocalypse. Here’s what that means for its strategy—and for how to stop it.

What is the Islamic State?

Where did it come from, and what are its intentions? The simplicity of these questions can be deceiving, and few Western leaders seem to know the answers. In December, The New York Times published confidential comments by Major General Michael K. Nagata, the Special Operations commander for the United States in the Middle East, admitting that he had hardly begun figuring out the Islamic State’s appeal. “We have not defeated the idea,” he said. “We do not even understand the idea.” In the past year, President Obama has referred to the Islamic State, variously, as “not Islamic” and as al-Qaeda’s “jayvee team,” statements that reflected confusion about the group, and may have contributed to significant strategic errors.

Some say the so-called sharing economy has gotten away from its central premise—sharing.

This past March, in an up-and-coming neighborhood of Portland, Maine, a group of residents rented a warehouse and opened a tool-lending library. The idea was to give locals access to everyday but expensive garage, kitchen, and landscaping tools—such as chainsaws, lawnmowers, wheelbarrows, a giant cider press, and soap molds—to save unnecessary expense as well as clutter in closets and tool sheds.

The residents had been inspired by similar tool-lending libraries across the country—in Columbus, Ohio; in Seattle, Washington; in Portland, Oregon. The ethos made sense to the Mainers. “We all have day jobs working to make a more sustainable world,” says Hazel Onsrud, one of the Maine Tool Library’s founders, who works in renewable energy. “I do not want to buy all of that stuff.”

A controversial treatment shows promise, especially for victims of trauma.

It’s straight out of a cartoon about hypnosis: A black-cloaked charlatan swings a pendulum in front of a patient, who dutifully watches and ping-pongs his eyes in turn. (This might be chased with the intonation, “You are getting sleeeeeepy...”)

Unlike most stereotypical images of mind alteration—“Psychiatric help, 5 cents” anyone?—this one is real. An obscure type of therapy known as EMDR, or Eye Movement Desensitization and Reprocessing, is gaining ground as a potential treatment for people who have experienced severe forms of trauma.

Here’s the idea: The person is told to focus on the troubling image or negative thought while simultaneously moving his or her eyes back and forth. To prompt this, the therapist might move his fingers from side to side, or he might use a tapping or waving of a wand. The patient is told to let her mind go blank and notice whatever sensations might come to mind. These steps are repeated throughout the session.